scholarly journals Novel Oral Anticoagulant versus Warfarin in Cancer Patients with Atrial Fibrillation: An 8-Year Population-Based Cohort Study

2020 ◽  
Vol 11 (1) ◽  
pp. 92-99 ◽  
Author(s):  
Victor Chien-Chia Wu ◽  
Chun-Li Wang ◽  
Yu-Tung Huang ◽  
Wen-Ching Lan ◽  
Michael Wu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Cancer Patients ◽  
Oral Anticoagulant ◽  
Population Based ◽  
Novel Oral Anticoagulant

scholarly journals Oral anticoagulant and reduced risk of dementia in patients with atrial fibrillation: A population-based cohort study

Heart Rhythm ◽  
2020 ◽  
Vol 17 (5) ◽  
pp. 706-713 ◽  
Author(s):  
Pajaree Mongkhon ◽  
Laura Fanning ◽  
Wallis C.Y. Lau ◽  
Gary Tse ◽  
Kui Kai Lau ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Oral Anticoagulant ◽  
Population Based ◽  
Reduced Risk

Impact of liver disease on oral anticoagulant prescription and major adverse events in patients with atrial fibrillation: analysis from a population-based cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Proietti ◽  
I Marzona ◽  
T Vannini ◽  
P Colacioppo ◽  
M Tettamanti ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Liver Disease ◽  
Risk Ratio ◽  
Major Bleeding ◽  
Oral Anticoagulant ◽  
Population Based ◽  
Primary Study ◽  
Secondary Bleeding ◽  
The Impact

Abstract Aims Data on the impact of liver disease (LD) in patients with atrial fibrillation (AF) and the role of oral anticoagulant (OAC) drugs for stroke prevention, are limited. We analysed the impact of LD and OAC treatment in determining stroke, major bleeding, all-cause death and secondary bleeding outcomes. Methods A retrospective observational population-based cohort study. The study cohort is derived from the administrative health databases of Lombardy region (>10 million inhabitants), Italy. All AF patients ≥40 years admitted to hospital from 2000 to 2018 were considered. AF and LD diagnosis were established using ICD9-CM codes. Use of OAC was determined with Anatomical Therapeutic Chemical (ATC) codes. Primary study outcomes were stroke, major bleeding and all-cause death. Results Among 393,507 AF patients, 16,168 (4.1%) had concomitant LD. LD AF patients were significantly less treated with OAC independent of associated clinical characteristics (OR: 0.96, 95% CI: 0.92–0.98). Concomitant LD was found associated with an increased risk in all the study outcomes (HR: 1.18, 95% CI: 1.11–1.25 for stroke; HR: 1.57, 95% CI: 1.47–1.66 for major bleeding; HR: 1.41, 95% CI: 1.39–1.44 for all-cause death. Use of OAC in patients with AF and LD resulted in a reduction in stroke (HR: 0.80, 95% CI: 0.70–0.92), major bleeding (HR: 0.86, 95% CI: 0.74–0.99) and all-cause death (HR: 0.85, 95% CI: 0.80–0.90), with similar results according to several clinically relevant subgroups. A net clinical benefit (NCB) analysis suggested a positive benefit/risk ratio in using OAC in AF patients with LD (NCB: 0.408, 95% CI: 0.375–0.472). Conclusions In AF patients, concomitant LD carries a significantly higher risk for all clinical outcomes. Use of OAC in AF patients with LD was associated with a significant benefit/risk ratio, even in high-risk patient subgroups. Funding Acknowledgement Type of funding source: None

Non-warfarin oral anticoagulant copayments and adherence in atrial fibrillation: A population-based cohort study

2021 ◽  
Vol 233 ◽  
pp. 109-121
Author(s):  
Benjamin N. Rome ◽  
Joshua J. Gagne ◽  
Jerry Avorn ◽  
Aaron S. Kesselheim
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Oral Anticoagulant ◽  
Population Based

Impact of liver disease on oral anticoagulant prescription and major adverse events in patients with atrial fibrillation: analysis from a population-based cohort study

2020 ◽  
Author(s):  
Marco Proietti ◽  
Irene Marzona ◽  
Tommaso Vannini ◽  
Pierluca Colacioppo ◽  
Mauro Tettamanti ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Liver Disease ◽  
Risk Ratio ◽  
Major Bleeding ◽  
Oral Anticoagulant ◽  
Population Based ◽  
Primary Study ◽  
Increased Risk ◽  
The Impact

Abstract Aims  Data on the impact of liver disease (LD) in patients with atrial fibrillation (AF) and the role of oral anticoagulant (OAC) drugs for stroke prevention are limited. Methods and results  A retrospective observational population-based cohort study on the administrative health databases of Lombardy region Italy. All AF patients ≥40 years admitted to hospital from 2000 to 2018 were considered. Atrial fibrillation and LD diagnosis were established using ICD9-CM codes. Use of OAC was determined with Anatomical Therapeutic Chemical codes. Primary study outcomes were stroke, major bleeding, and all-cause death. Among 393 507 AF patients, 16 168 (4.1%) had concomitant LD. Liver disease AF patients were significantly less treated with OAC. Concomitant LD was associated with an increased risk in all the study outcomes [hazard ratio (HR): 1.18, 95% confidence interval (CI): 1.11–1.25 for stroke; HR: 1.57, 95% CI: 1.47–1.66 for major bleeding; HR: 1.41, 95% CI: 1.39–1.44 for all-cause death]. Use of OAC in patients with AF and LD resulted in a reduction in stroke (HR: 0.80, 95% CI: 0.70–0.92), major bleeding (HR: 0.86, 95% CI: 0.74–0.99), and all-cause death (HR: 0.77, 95% CI: 0.73–0.80), with similar results according to subgroups. A net clinical benefit (NCB) analysis suggested a positive benefit/risk ratio in using OAC in AF patients with LD (NCB: 0.408, 95% CI: 0.375–0.472). Conclusion In AF patients, concomitant LD carries a significantly higher risk for all clinical outcomes. Use of OAC in AF patients with LD was associated with a significant favourable benefit/risk ratio, even in high-risk patient subgroups.

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